复合技术治疗颈动脉次全闭塞伴远端完全塌陷的疗效分析  

Analysis of therapeutic efficacy of hybrid surgery for carotid near-occlusion with full collapse

作　　者：张建彬[1] 陈洁[1] 贺斌 刘鹏[1] 叶志东[1] Fan Xueqiang Zhang Jianbin;Chen Jie;He Bin;Fan Xueqiang;Liu Peng;Ye Zhidong(Department of Cardiovascular Surgery,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院心脏血管外科,北京100029

出　　处：《中国血管外科杂志（电子版）》2024年第1期36-39,共4页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：中央高水平医院临床科研业务费专项项目(2023-NHLHCRF-YYPPLC-TJ-26)。

摘　　要：目的探讨复合技术治疗颈动脉次全闭塞(carotid artery near-occlusion,CNO)伴远端完全塌陷的疗效。方法回顾性收集中日友好医院2016年1月至2021年1月接受复合技术治疗的45例CNO伴远端完全塌陷患者临床资料,分析其临床特点、影像学检查、治疗及预后情况。结果技术成功率100%。患者术中均未使用转流管,32例使用人工血管补片,2例使用颈外静脉补片,11例未使用补片。29例患者内膜剥脱后颈动脉血运重建满意,未行进一步治疗;16例行普通球囊扩张;均未行支架植入。患者围手术期的主要终点事件发生率为6.66%(3例),包括1例心肌梗死,2例同侧脑卒中,术后高灌注综合征发生率8.88%,无严重颅神经损伤发生。患者术后1年的主要终点事件发生率13.2%(6例),2例发生急性心肌梗死,其中1例死亡;1例术后6个月发生同侧颈内动脉重度狭窄。结论复合技术治疗CNO伴远端完全塌陷可以取得较好的近期疗效。Objective To explore the therapeutic efficacy of hybrid surgery for carotid near-occlusion(CNO)with full collapse.Methods The clinical data of CNO patients with full collapse who received hybrid surgery at China-Japan Friendship Hospital from January 2016 to January 2021 were collected retrospectively,and their clinical characteristics,imaging examinations,treatment and prognosis were analyzed.Results The technical success rate was 100%.Shunt was not used in all patients.32 cases used artificial vascular patch,2 cases used external jugular vein patch,and the carotid artery was sutured directly in 11 cases.29 patients showed satisfactory recanalization after carotid endarterectomy without further treatment,16 patients underwent conventional balloon dilation,and no patient received stent placement.The incidence rate of primary endpoint events in the perioperative period was 6.66%(3 cases),including 1 case of myocardial infarction and 2 cases of ipsilateral stroke.The incidence rate of postoperative hyperperfusion syndrome was 8.88%.There was no serious cranial nerve injury.The incidence of primary endpoint events was 13.2%one year after surgery.Two patients suffered acute myocardial infarction and one patient died,and one patient developed severe stenosis of the ipsilateral internal carotid artery 6 months after surgery.Conclusion Hybrid surgery can achieve good short-term therapeutic efficacy for CNO patients with full collapse.

关 键 词：颈动脉次全闭塞 复合技术 颈动脉狭窄 颈动脉内膜剥脱术 

分 类 号：R654.3[医药卫生—外科学]